Billy Allen Dudley v. HHS - DPT, encephalopathy and/or hypotensive-hyporesponsive shock collapse (2002)

Billy Allen Dudley, born October 8, 1983, received his first DPT vaccination on December 2, 1983. Two days later, on December 4, 1983, he was found not breathing and later pronounced dead.

The medical examiner initially identified the cause of death as 'crib death' or Sudden Infant Death Syndrome (SIDS). Petitioner alleged that Billy died from vaccine-related encephalopathy and/or hypotensive-hyporesponsive shock collapse within three days of his vaccination.

Petitioner described symptoms following the vaccination including increased sleep, irritability, poor feeding, appearing 'spacey,' and being 'limp.' Petitioner's experts, geneticist Mark Geier and pathologist John J. Shane, testified that Billy suffered an encephalopathy and/or a hypotonic-hyporesponsive episode (HHE) caused by the DPT vaccine, relying in part on the mother's description of symptoms and autopsy findings of cerebral edema.

Respondent's experts, pediatric neurologist Walter Molofsky and pediatric pathologist Enid Gilbert-Barness, opined that Billy's death was caused by SIDS and not the vaccine. The special master denied compensation, finding the mother's testimony unreliable due to the passage of time and psychological factors, and that contemporaneous records did not indicate the alleged symptoms.

The special master also found respondent's experts more persuasive, particularly Dr. Gilbert-Barness, and concluded that SIDS was the cause of death.

The Court of Federal Claims, in an opinion by Judge Wilson, reversed and remanded the special master's decision. The court found that the special master erred by considering SIDS, an unexplained disease process, to rebut the presumption of a Table Injury, which is impermissible under the Vaccine Act.

The court noted that the special master's analysis of petitioner's proof of a Table Injury was intertwined with consideration of SIDS evidence, effectively raising the burden of proof beyond the "preponderance" standard. The court also found that the special master's decision omitted discussion of sibling sensitivity and potentially relied on a factual error regarding the petitioner's statement about Billy appearing normal.

The case was remanded for further fact-finding and reevaluation of the evidence for a Table Injury, without reference to SIDS as an alternative cause. The court granted petitioner's motion to amend her motion for review but denied her motion to file a well-child exam of Billy's brother, Adam Dudley, on review, as the court is limited to the record before the special master.

Petitioner was represented by counsel, and respondent was represented by counsel. The Special Master's decision was issued on February 2, 2001.